Responses: Question One

Thank you to everyone who completed the harm reduction philosophy survey- we received well over 100 responses! Now the fun begins- analyzing the results. There are a number of ways to do this, and we are going to try several (for example, running fancy statistics). But today, we’re going to start a series where we unpack one survey question at a time, beginning with question one.

Note: while the bulk of people gave us full permission to use their responses and names we have taken the decision to present quotes with just the submitters initials.

How did you come to believe in harm reduction?

An open-ended question that led to a variety of responses. We grouped responses into a number of themes including lived experience, human rights, pragmatism, truth, necessity, mentorship, and- it’s no belief at all! We hope you enjoy reading these excerpts. If something resonates with you (or annoys you), keep the conversation by completing the form yourself.

Lived Experience

Several respondents cited their lived experience, particularly during the outbreak of HIV/AIDS in the 1980s. JM wrote:

“I worked in Newcastle upon Tyne in the drugs field in the mid-1980’s. First city over the border from Scotland. Edinburgh had no needle exchanges. I was also in local Lesbian Gay activist group. I was at a funeral for someone felled by AIDS every single week. I also noticed that my gay male friends suffered lots of stigma and prejudice but nowhere near as much as the IV heroin using service users I worked with. For me Harm reduction was the only moral choice and fighting stigma was always a part of it.”

Similar to JM, a number of respondents recalled coming in contact with a needle syringe program- either as a person who uses drugs, service provider, or both.

“I volunteered at a street clinic in downtown Calgary (called the Calgary Urban Projects Society) that included a needle exchange program. I witnessed the dignity with which people who inject drugs were treated by the nurses and physicians and realized that harm reduction was really about respecting people as whole people.”

“Respecting people as whole people.”

Nice. Which brings us to the next theme of our analysis…

Human Rights

“When I started to realise HR held all life as having value, it clicked with me.” – MM

“I am a drug user and I see harm reduction, at its core, as being a practice that works towards putting all the things in place that need to exist for PWUD to have their human rights upheld.” AOM

In addition to human dignity, others recognized the importance of autonomy. AD wrote:

“I believe that humans have the right to do to their own body what they want to, including taking drugs, and have the right to not expect to die as a consequence of their choices. I see no difference in how people choose to access their brain chemistry, be that via substances, sex, sport, yoga or religion, and that if we feel compelled to make activities safer, that must apply to all activities without moral judgment.”

Comparing substance use to socially approved mind-altering activities such as exercise- nice!

Pragmatism

On the flip side, a number of respondents cited harm reduction as something they turned to out of raw necessity. JR shared that she

“Experienced the loss of several loved ones, some of which could have been saved had harm reduction efforts been available.”

ST shared:

“When a mother let me know that the Naloxone I gave her was used and saved her son’s life.”

And SW wrote:

“It became clear in the 90s that harm reduction strategies introduced in the 80s successfully prevented a HIV/AIDS epidemic in Australia.”

What all these voices have in common is that they were convinced that harm reduction had pragmatic effects in the world. Sometimes, this was contrasted to an abstinence-only approach to drugs and other behaviors.

“I was raised around abstinence-based ideas, because my mother went into recovery when I was a teenager. Later I lived in NYC and so many friends got involved in heroin. It was so obvious that abstinence scolding didn’t help. A friend worked in early needle exchange and brought me into the concept of HR.” – SC

G put it this way:

“Saying “just stop drinking/using” is unrealistic. It’s important to help people reduce the harm of substances they are using as it will inevitably save lives.”

This is not to say harm reduction is opposed to voluntary abstinence! We thank LM for the following metaphor:

“All people have a choice, we just make sure they see the whole menu.”

It’s not a ‘belief’ at all

This was a surprisingly common response. One respondent wrote:

“I don’t know that I ‘came to believe’ in Harm Reduction. Rather I see harm reduction as a common sense of sorts that is innate and not something to ‘believe in.”

Similarly, Valery Schuman wrote:

“The first time I heard the term and began to understand the principles, it just made sense to me. It reflected the way that I used substances as a young person. It also reflected my understanding that some/most people use drugs non-problematically.”

One way to think of this is that “harm reduction” gave people a label to describe an understanding they had already come to. Neat! Putting it bluntly, BL wrote:

“Harm reduction isn’t really a belief to me. I associate beliefs with opinions. From my perspective, harm reduction is knowledge, not a belief.”

Individuals

Finally, many respondents cited individual people as their inspiration for believing in harm reduction. These included mentors, people who use drugs, services providers, researchers and writers, and volunteers and workers at needle syringe programs.

Some of these people are still with us, some of them are not. But they’re all part of a movement that has grown beyond any one of us. They, in addition to lived experience, human rights, pragmatism, and common sense, are just some of the reasons why we believe in harm reduction.

Lets keep this going

If you haven’t already done so, please take some time to complete the first of our questionaires. If you want to prepare your responses you can download a PDF version and then copy/paste your answers from Word when you’re ready.